Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/101

Click to flip

101 Cards in this Set

  • Front
  • Back
Where is most of the refractive power of the eye contained?
Cornea = 39-48 diopters

Lens = 15-24 diopters
What determines if you are Myopic or Hyperopic?
the shape fo the eyeball
-
-
What part of the eye is immunologically privileged? Why?
Anterior Chamber b/c it doesn't receive blood flow
Basilar Skull Fracture
What is the cause of these symptoms?
Basilar Skull Fracture
What is the cause of this?
Exophthalmos

Fatty tissue behind the globe may be infiltrated by myxedematous tissue
-Grave's disease
What is this called? What is the cause?
Blepharitis
Acute inflammation of the eyelids, caused by allergen, mild trauma, etc
Hordeolum = Sty
Acute Folliculitis of the Meibomain or Zeis glands (sebaceous glands)
What is the treatment for Hordeolum (Sty)?
Hot compresses will ususally cause the Sty to "point" & drain.

Alternatively, it can be excised
-Antibiotic are rarely necessary
What is the most common carcinoma of the eyelid? 2nd most common?
Basal Cell CA = predilection for the lower eyelid & medial canthus

Sebaceous CA
Subconjunctival Hemorrhage = usually due to minimal trauma
-coughing, sneezing, vomiting

Does not require treatment, but warn patient that blood will change color like a bruise
What is seen here? What is the treatment?
What type of Conjunctivitis is most common?
Allergic Conjunctivitis
What bacteria are the most common cause of Bacterial Conjunctivitis (pink eye)?
H. influenza

S. pneumoniae
What is the cause of Epidemic Keratoconjunctivitis that is usually contracted from under-chlorinated public swimming pools?
Adenovirus
This is the leading cause of blindness worldwide
Chlamydia trachomatis
This is the cause of Ophthalmia Neonatorum
Gonoccal
Pink Eye due to H. influenza
-kids complain of waking up with their eye matted shut from pus
Dx?
What is the treatment for Conjunctivitis?
1. Vasoconstrictors

2. Antibiotics
-topical Erythromycin is preferred
-Contact lens-wearers should receive coverage for Pseudomonas = Ciprofloxacin, Ofloxacin, or Tobramycin

3. Ophthalmia Neonatorum requires systemic therapy = Penicillin or Ceftriaxone
What may dry eyes cause?
Drying & scarring of the Cornea
What group of people is Idiopathic Dry Eye common in? What is the treatment?
Older women = may be associated with Menopause

May also occur in younger, pregnant women

Tx = Artificial tears
With what syndrome do you have dry eyes?
Sjogren Syndrome = Keratoconjunctivitis Sicca
Vascularized conjunctival tissue, which may grow over the iris, obscuring vision
Pterygium
What people does Pterygium commonly occur in? What is the treatment?
Elderly

Surgical excision, often return so must be re-excised
Pterygium
What is this?
This part of the Eye has more pain nerve fibers per millimeter squared than any other tissue in the body
Cornea
T or F: Corneal epithelium heals faster than any other tissue in the body
True
When does the Corneal epithelium not regenerate?
When the Basement Membrane (Descemet's membrane) is injured
How are Corneal Abrasions usually treated?
1. Patch affected eye, usually heals within 24 hours
-Antibiotics are rarely necessary

2. Medicate for pain
Eye problem in which the patient usually believes there is something in the eye, but physical exam reveals only conjunctivitis. Fluorescein may worsen the conjunctivitis
Corneal Abrasion
What do you not treat Herpex Simplex Corneal Ulcers with?
Corticosteroids
Herpes Simplex Keratitis
-"chinese character"
What is this?
Herpes Simplex Keratitis
-"chinese character"
What is your diagnosis?
Acanthemeba = severe keratoconjunctivitis in pts who do not clean their contacts properly
What is the cause of this?
This causes Keratoconjunctivitis in patients who do not clean their contancts lenses properly
Acanthamoeba
The patient was a 61 year old man who was mowing his lawn with a power mower. He was not wearing eye protection. He got something in his eye, but simply rubbed it and kept on mowing. By the next day the eye was swollen, red and pruritic. He consulted an ophthalmologist, who prescribed topical steroids. His vision worsened, and he consulted another ophthalmologist.
Fusarium
Fusarium
Dx?
Paecilomyces
This is from a patient who had Elective Radial Keratotomy for myopia. Dx?
A collection of disorders featuring optic neuropathy, accompanied by a characteristic excavation of the optic nerve head and progressive loss of visual field sensitivity
Glaucoma
What is Glaucoma?
Any of a group of eye diseases characterized by abnormally high intraocular fluid pressure, damaged optic disk, hardening of the eyeball, and partial to complete loss of vision
What is the most common type of Glaucoma?
Primary Open-Angle Glaucoma
Gradually increasing intraocular pressure, leading to visual impairment &, eventually, blindness
Primary Open-Angle Glaucoma
Glaucoma which is an ocular emergency, requiring intervention within 24-48 hours
Primary Closed-angle Glaucoma
Describe the normal flow of Aqueous Humor
1. Fluid is produced in the Ciliary Body in the Posterior Chamber
2. Fluid then comes thru into the Cornea
3. Fluid exits thru Canal of Schlemm
Primary Angle Closure Glaucoma
-transient apposition of the Iris at the Pupillary Margin to the Lens blocks passage of Aqueous Humor from the Posterior Chamber to the Anterior Chamber
-pressure builds up in the Posterior Chamber, bowing the Iris forward & occluding the trabecular meshwork
What is this picture showing?
Neovascular Membrane = Secondary Glaucoma
What is this picture showing?
What are some causes of Cataracts?
1. Advanced age = MC
2. Diabetes Mellitus = osmotic damage
3. Infection = Rubella, CMV
4. Toxins or Drugs
5. Autoimmune diseases = Scleroderma
6. Physical agents = UV light, radiation
What is the most common cause of Cataracts in the US?
Treatment?
Aging = Senile Cataracts = "senile degeneration" of lens fibers, thought to be related to UV exposure or aging

Lens replacement
Early Cataract
What is seen here?
Advanced Cataract
What is seen here?
Cataract
What is seen here?
Cataract of the Lens
What is seen here?
List the layers of the Retina
1. Pigmented epithelium (Outer layer)
2. Photoreceptors; bacillary layer (outer and inner segments of cone and rod photoreceptors)
3. External (outer) limiting membrane
4. Outer nuclear (cell bodies of cones and rods)
5. Outer plexiform (cone and rod axons, horizontal cell dendrites, bipolar dendrites)
6. Inner nuclear (nuclei of horizontal cells, bipolar cells, amacrine cells, and Müller cells)
7. Inner plexiform (axons of bipolar cells and amacrine cells, dendrites of ganglion cells)
8. Ganglion cells (nuclei of ganglion cells and displaced amacrine cells)
9. Axons (nerve fibers from ganglion cells traversing the retina to leave the eye at the optic disk)
10. Internal limiting membrane (separates the retina from the vitreous)
What are the 4 layers beneath the outermost Pigmented epithelium of the Retina, from inside (closest to Retina) to outside?
1. Bruch's Membrane = separates the Pigmented Epithelium of the retina from the Choroid
2. Choriocapillaries
3. Choroidal blood vessels
4. Sclera = white part of eye
Temporal Arteritis = "Giant Cell" Arteritis

can affect the Ophthalmic Artery, causing retinal infarction
What is shown here? What is the significance?
Retina showing:
1. Arteriolar narrowing (AV nicking)
2. Hemorrhage
3. Microaneurysms
4. Exudates
5. Cotton Wool spots = infarcted nerve fiber layer
Hypertensive Retinopathy
Hypertensive Retinopathy
-Arteriolar narrowing (AV nicking)
-Hemorrhage
-Microaneurysms
-Exudates
-Cotton Wool Spots (infarcted nerve fiber layer)
What is seen here?
Diabetic Retinopathy that has the following:
1. Hemorrhage
2. Microaneurysms
3. Exudates

Does not impair vision
Background (Non-proliferative) Retinopathy
Background (Non-proliferative) Retinopathy
Dx?
Occurs later in Diabetes, often within 5 years of death from vascular causes

Characterized by neo-vascular proliferation of the retina, which obscures vision

Retinal detachment & blindness are common
Proliferative Retinopathy
Proliferative Retinopathy
Dx?
What is an alternate name for Retinopathy of Prematurity?
Retrolental Fibroplasia
Describe Retinopathy of Prematurity (Retrolental Fibroplasia)
1. Caused by high oxygen tension in Premature infants due to therapeutic oxygen

2. Proliferative retinopathy occurs, similar to that in late stage Diabetes

3. May be accompanied by Retinal Detachment & a Fibrovascular mass behind the Lens
Systemic mycoses that is endemic in the Mississippi & Ohio River valleys that is contracted from inhalation of air-borne spores from bird or bat droppings; can cause RETINITIS
Histoplasma captulatum
Protozoa that is usually congenital in origin & may reactivate in HIV disease or iatrogenic immunosuppression causing brain abscesses & Retinitis
Toxoplasmosis
Virus that can cause Retinitis
CMV
Nematode that is found in Cats & Dogs; can cause Visceral Larvae Migrans resulting in Retinitis leading to blindness; most common in pediatric age group
Toxocara
REtinitis caused by CMV
What is seen here?
Retinitis caused by Histoplasmosis
-inflammation has gone deep to the Pigmented Epithelium layer = see black appearance
What is seen here?
Retinitis from Toxoplasmosis
-has gone into Pigmented Epithelium layer
What is seen here?
Toxocara
-larvae is migrating across the eye in the Aqueous Humor right behind the lens
What is seen here?
List the 3 types of Retinal Detachment
1. Rhegmatogenous
2. Traction
3. Exudative
Retinal Detachment that is associated with a retinal tear
Rhegmatogenous
Retinal Detachment in which adhesions are formed during diabetic retinopathy or infections & pull the retina away from the pigment layer
Traction
Retinal Detachment in which a collection of fluid between the retina & the pigment epithelium occurs during Choroiditis, Choroid Hemangioma, or Melanoma
Exudative
Most common cause of decreased visual acuity in the US
Macular Degeneration
What is the cause of Macular Degeneration?
Age-related, possiblly due to toxins (Chloroquine)

may also be related to smoking, hyperlipidemia, or genetic causes
Papilledema
What is seen here?
What is Papilledema?
Optic Disc swelling that is caused by increased Intracranial pressure
What do you NOT want to do if a patient has Papilledema?
perform a Spinal Tap

Increased intracranial pressure will cause Cerebellar Tonsils to herniate down into the Foramen Magnum -> press on the Medulla where Respiratory Centers are -> death
What is the most common malignancy of the eye?
Metastatic carcinoma
-usually involving the Uveal Tract (iris, choroid, & ciliary body)
What does Uveal Tract Melanoma arise from?

What part of the eye does NOT form Melanomas?
Arises from Melanocytes or Nevi in the Uvea (vascular lining of the eye, including the Choroid)

Retinal Pigment Layer
What race is more likely to get Uveal tract Melanoma?
Caucasians
What is the classical vignette for a Uveal tract Melanoma?
patient presents with an enlarged liver & a glass eye

*Uveal tract Melanoma commonly metastasizes Hematogenously to the Liver
How is Uveal tract Melanoma treated & what is the prognosis?
Enucleation

Good prognosis if found early = 50% 15 year survival
Anterior Segment Melanoma
-pupil tractions is seen
What is seen here?
Anterior Segment Melanoma
What is seen here?
Posterior Segment Melanoma
What is seen here?
Posterior Segment Melanoma
WHat is seen here?
Melanoma
What is seen here?
Malignant neoplasm that arises from immature retinal neurons & is the most common intraocular neoplasm of childhood
-usually presents within the first 2 years of life
Retinoblastoma
What percent of Retinoblastoma is bilateral?
up to 25%
What type of gene is the Rb gene? What chromosome is it located on?
Tumor Suppressor Gene

Chr. 13
How is Retinoblastoma treated?

Where may it spread to?
Enucleation & chemotherapy

CNS along the optic nerve
Explain the pathogenesis of Retinoblastoma
Knudson's "two-hit" hypothesis:
1. First deletion si inherited in germ line in familial cases or occurs as a somatic mutation in sporadic cases

2. Second deletion results from somatic mutation in both familial % sporadic cases
What does Retinoblastoma increase the risk of having?
Osteosarcoma
What percent of REtinoblastoma cases are inherited?
6-8%

the rest are spontaneous
Retinoblastoma
-Red Reflex is something you look for at 2-3 ft away thru your ophthalmoscope
-here you see a White reflex due to tumor
What is seen here?
REtinoblastoma
-fleshy tumor filling into the Vitreous Humor
What is seen here?
REtinoblastoma = "little blue cells"
What is seen here?
Retinoblastoma with "rosettes"
What is seen here?